MEDICARE: CHRISTY L KRETZER FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	10610-NP	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427298082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTY L KRETZER FNP-BC

Provider Business Mailing Address
First Line	:	280 S MCCLURE RD
Second Line	:
City	:	LIMA
State	:	OH
Zip	:	45801-9711
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	280 S MCCLURE RD
Second Line	:
City	:	LIMA
State	:	OH
Zip	:	45801-9711
Country	:	US
Telephone Number	:	567-204-6386
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2009
Last Update Date	:	08/27/2020

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